HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
g;= f T r- Building&Code Regulation Division
we 2300 Virginia Avenue
i
o Fort Pierce, FL 34982
-- - - 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
1, Christopher Collins , licensed as a(n)Contractor*/Engineer/Architect
(Please print name.&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 'If 20 2 1 did personally inspect the roof deck nailing
(Date)
work at: tom' C�i
(Job site address)
Bas upon tha ination I au determined the installation was done according to the current
e tion of th I Existi Bui ing Code Section 611 or the product approval submitted (whichever is
ost stri t
I
CCC-058011
ignature and Seal License#
STATE OF FLORIDA J/
COUNTYOF
SS to and subscribed before me this a-b day of ✓�1 20�
by S 1• Who is personally known to me or who has produced
L as identification.
Notary Public,State of.Fj9rida
Signature of Notary: 4i t
Commission Number: (Seal)
En 01/19/2011
CATHYJ r&ae
S
Notary Public- Florida
Commission F 221708 «
My Comm.Expires May 10,2019.r
Bonded through National N otaAssn.
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